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@#Objective To study the effect of Tangeretin on non-small cell lung cancer (NSCLC) and the tumor stemness, and to find the molecular mechanism of its effect. Methods We used cell counting and cell cloning experiments to study the effect of Tangeretin on the proliferation of NSCLC cells in vitro. The effect of Tangeretin on the invasion of NSCLC cells was detected by transwell assay. We detected the effect of Tangeretin on the proliferation of NSCLC cells in vivo by nude mouse tumor-bearing experiment. The effect of Tangeretin on tumor stemness of NSCLC cells was detected by self-renew assay, and CD133 and Nanog protein expressions. The expressions of PI3K/AKT/mTOR signaling pathway-related proteins were detected by Western blotting (WB). Results Tangeretin had a good inhibitory effect on the proliferation of NSCLC cells in vivo and in vitro. Cell counting experiment, clonal formation experiment and nude mouse tumor-bearing experiment showed that Tangeretin could inhibit the proliferation activity, clonal formation ability, and tumor size of NSCLC cells in vivo. Self-renew experiments showed that Tangeretin could inhibit the self-renew ability of NSCLC cells. WB experiments showed that Tangeretin inhibited the expressions of tumor stemness markers CD133 and Nanog in NSCLC cells. Tangeretin could inhibit the activation of PI3K/AKT/mTOR signaling pathway-related proteins in NSCLC cells, and the activation of PI3K/AKT/mTOR signaling pathway could partially remit the inhibitory effect of Tangeretin on tumor stemness of NSCLC cells. Conclusion Tangeretin can inhibit the tumor stemness of NSCLC cells, which may be related to the regulation of PI3K/AKT/mTOR signaling pathway.
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BACKGROUND: Preliminary study found that polylactic acid composite material could accelerate the bone construction rate, and the underlying mechanism still needs to be studied further. OBJECTIVE: To investigate the effect of lactic acid at different concentrations on osteoclast differentiation of mononuclear cells in mice. METHODS: Mouse RAW264.7 cells were cultured in DMEM with 0 (control group), 5, 10 and 20 mmol/L lactic acid, respectively, under the induction of 50 µg/L RANKL for 5 days. The effect of lactic acid concentration on the cell proliferation rate was analyzed by cell counting kit-8 assay. Tartrate resistant acid phosphatase positive polykaryotic cells were stained and counted with tartrate resistant acid phosphatase staining kit. mRNA expression levels of acid phosphatase 5, nuclear factor of activated T-cells 1 and RANK were detected by RT-PCR. Protein expression levels of cathepsin K and nuclear factor of activated T-cells 1 were detected by western blot assay. RESULTS AND CONCLUSION: (1) 5 mmol/L lactic acid produced the highest proliferation rate of raw264.7 cells, whereas the 20 mmol/L lactic acid produced lowest cell proliferation rate. Compared with the control group, the proliferation rate of raw264.7 cells by 10 mmol/L lactic acid was insignificant. (2) Tartrate resistant acid phosphatase staining showed the highest positive rate and mRNA expression levels of acid phosphatase 5, nuclear factor of activated T-cells 1 and RANK under the condition of 10 mmol/L lactic acid. (3) With the increase of lactic acid concentration, the expression level of cathepsin K increased, while the expression level of nuclear factor of activated T-cells 1 was on a decline. (4) Under the current experimental conditions, with the increase of lactic acid concentration, the ability of lactic acid to promote the osteoclast differentiation of mouse RAW264.7 cells is firstly increased and then decreased, and 10 mmol/L lactic acid was the optimal concentration to promote the osteoclast differentiation of mouse RAW264.7 cells. Lactic acid can affect the osteoclastic differentiation of mouse raw264.7 cells by nuclear factor of activated T-cells 1 in nuclear factor-KB signaling pathway.
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BACKGROUND: Proximal junctional kyphosis is a common complication after spinal deformity surgery, which can lead to a variety of adverse clinical outcomes. Therefore, it is necessary to analyze the risk factors that may lead to proximal junctional kyphosis after surgery, in order to expand our understanding of proximal junctional kyphosis and provide guidance for its prevention. OBJECTIVE: To evaluate the risk factors of proximal junctional kyphosis after spinal deformity surgery using meta-analysis. METHODS: A systematic literature search was performed using PubMed, EMbase, Cochrane, CNKI and Wanfang Medical Database (up to May 2019). The quality of literatures was assessed and selected according to the inclusion criteria and exclusion criteria. Relevant data were extracted. RevMan 5.3 software was used for data analysis and the data were dealt by meta-analysis. The meta-analysis results were evaluated. RESULTS AND CONCLUSION: (1) This study included 26 studies involving 4 498 patients of whom 921 with proximal junctional kyphosis. The incidence of proximal junctional kyphosis after spinal orthopedic surgery was 25%. (2) There were significant differences between the proximal junctional kyphosis and non-proximal junctional kyphosis groups in age, body mass index, osteoporosis, number of surgical vertebral bodies, the upper instrumented vertebra to the thoracolumbar segment (T10-L1), the lower instrumented vertebra to the sacrum/pelvis/ilium, postoperative proximal kyphosis angle, lumbar lordosis and sagittal vertical axis, changes in proximal kyphosis angle, lumbar lordosis and sagittal vertical axis (P 0.05). (4) Our meta-analysis showed that age, body mass index, osteoporosis, the number of operative vertebrae > 5 at fixation segment, the upper instrumented vertebra internal fixation to thoracolumbar segment (T10-L1), the lower instrumented vertebra fixation to sacrum/pelvis/ilium, postoperative proximal kyphosis angle, lumbar lordosis and sagittal vertical axis, changes in proximal kyphosis angle, lumbar lordosis and sagittal vertical axis were the main risk factors for proximal junctional kyphosis. The incidence of proximal junctional kyphosis can be reduced by intervening the high-risk population and making the suitable surgical procedures. Proximal junctional kyphosis was due to a variety of non-surgical and surgical factors. More rigorous epidemiological studies are needed to provide reliable evidence for reducing the incidence of proximal junctional kyphosis.
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BACKGROUND: Currently, surgical methods for the treatment of degenerative scoliosis include simple decompression and decompression combined with internal fixation. However, there is still controversy over the choice of fixation and fusion segment in surgery, which requires more reliable evidence-based medical evidence for reference. OBJECTIVE: To evaluate the clinical efficacy and complication of short versus long segments of internal fixation for the treatment of degenerative scoliosis using meta-analysis. METHODS: CNKI, Wanfang Database, VIP, CBM, EMBase, PubMed, Web of Science, and Cochrane Library were searched to collect the randomized and non-randomized controlled studies which compared long fusion with short fusion in the treatment of degenerative scoliosis from inception to February 2019. Relevant conference papers and authoritative journals in the field were retrieved manually. The quality of the included studies was assessed by two evaluation members according to the Cochrane collaboration network standard or the Newcastle-Ottawa Scale. The included studies were analyzed by using RevMan 5.3 software. RESULTS AND CONCLUSION: (1) A total of 20 articles were included, involving a sample of 1 329 individuals. Long segment group consisted of 601 cases, and short segment group consisted of 728 cases. (2) The meta-analysis results showed that long-segment internal fixation surgery had better improvement of coronal Cobb angle (P=0.000 4), coronal balance (P=0.000 2), Oswestry disability index (P=0.003) and visual analogue scale score (P 0.05). (4) These findings verify that long-segment internal fixation is superior to short-segment internal fixation in the correction of scoliosis, but the recovery is slow and the incidence of some complications after operation is high. It should be considered comprehensively when selecting specific surgical procedures.
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BACKGROUND: In recent years, with the deepening of medical research, it has been found that PI3K/AKT signaling pathway has a regulatory effect on vascular repair regeneration, osteoblast differentiation and proliferation, and osteoclast bone differentiation. This is very important for the treatment of femoral head necrosis. OBJECTIVE: To provide a brief overview of the main research progress in mechanisms of PI3K/AKT signaling pathway regulating femoral head necrosis in recent years, aiming to provide new ideas for the treatment of osteonecrosis of the femoral head in the future. METHODS: PubMed and MEDLINE database, Wanfang, CNKI, WIPO and CBM database were searched from 2012 to 2019, for relevant domestic and foreign literatures, including: (1) epidemiological study of osteonecrosis of the femoral head and related pathogenesis; (2) PI3K/AKT pathway related mechanism; (3) research literature on the effects of PI3K/AKT on factors related to vascular repair and regeneration; (4) research literature on the regulation of PI3K/AKT on osteoblast differentiation and proliferation-related factors; (5) literature on the regulation of PI3K/AKT on functional factors related to osteoclast differentiation. A total of 62 literatures were included for analysis and summary. RESULTS AND CONCLUSION: (1) The PI3K/AKT signaling pathway has been proven to be effective in the regulation of vascular repair regeneration, osteoblast differentiation, proliferation, apoptosis and osteoclast differentiation. After understanding these pathways, research and development of related drugs to improve the success rate of early conservative treatment of osteonecrosis of the femoral head have great development prospects and potential, opening up a new path for future orthopedic surgeons to treat osteonecrosis of the femoral head, and bringing new hope to patients and their families. (2) According to the different osteonecrosis of the femoral head conditions of patients, how to use PI3K/AKT signaling pathway to guide treatment becomes a breakthrough point and challenge of this technology, and more research is needed later.
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BACKGROUND: Although mechanical alignment technique ensures the long-term survival rate of knee arthrosis, some patients are still not satisfied with the effect of total knee arthroplasty and the function of knee joint after operation. OBJECTIVE: Meta-analysis was used to evaluate the effect of kinematic alignment technique and mechanical alignment technique in the guidance of total knee arthroplasty. METHODS: The literature of clinical controlled study of kinematic alignment and mechanical alignment in the guidance of total knee arthroplasty published from the date of establishment to July 2019 was searched in Chinese Biomedical Literature Database, Wanfang data, CNKI, VIP data, PubMed, Cochrane Library, and Embase. The literature was screened, and evaluated; data were extracted. Review Manager 5.3 software was used for statistical analysis. RESULTS AND CONCLUSION: (1) A total of 945 cases were included in 12 articles, including 470 cases in kinematic alignment group and 475 cases in mechanical alignment group. (2) The results of meta-analysis showed that the operation time was shorter in the kinematic alignment group than in the mechanical alignment group [MD=-15.44, 95%C/(-27.16, -3.71)]. Western Ontario and McMaster University Osteoarthritis Index was better in the kinematic alignment group than in the mechanical alignment group [MD=-8.40, 95%C/(-15.39, -1.40)]. Oxford knee score was better in the kinematic alignment group than in the mechanical alignment group [M7=4.72, 95%C/(0.24, 9.21)]. Distal angle of mechanical lateral femur and proximal angle of mechanical medial tibia were significantly larger in the mechanical alignment group than in the kinematic alignment group (all P 0.05). (4) The function of knee joint after kinematic alignment for guiding total knee arthroplasty was better than that in mechanical alignment group. However, the imaging and perioperative results were similar, and the incidence of complications was not increased after operation. It is suggested that kinematic alignment may be a lower extremity force alignment method to guide total knee arthroplasty.
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BACKGROUND: Adolescent idiopathic scoliosis causes changes in the structure and stress of the spine. The lumbar spine bears the greatest load in the spine, and the pelvis also plays the role of transmitting gravity. Therefore, the biomechanical analysis of the lumbar spine and pelvis in adolescent idiopathic scoliosis with lumbar major curve is particularly important. OBJECTIVE: To establish the three-dimensional digital model of lumbar spine-pelvis in adolescent idiopathic scoliosis and undergo finite element analysis. METHODS: The CT microscopic data of the lumbar spine-pelvis in a 13-year-old idiopathic scoliosis volunteer were used to reconstruct the three-dimensional digital model using mimics 15.0 software. The preliminary geometric model was established by Pro/E 5.0 software and imported into Hypermesh 13.0 for mesh generation. The model was finally subjected to finite element analysis by Abaqus 6.14 software. The displacement, stress changes of the model under six load conditions, and the stress changes of each vertebra and intervertebral disc were analyzed. The study was approved by the ethical committee of the hospital, and the patient family member signed the informed consents. RESULTS AND CONCLUSION: (1) A three-dimensional finite element model of the lumbar spine-pelvis in adolescent idiopathic scoliosis was established. (2) Under the six kinds of loading conditions, the displacement of the upper part of the Li was the largest in the left and right flexion, and the displacement of the lower end of the tibia was the largest in the flexion. (3) The right margin of the intervertebral disc had highest stress under right flexion. Under anterior flexion position, the lumbar intervertebral disc was subjected to the highest stress on the anterior margin and the stress on the left margin was the least stressed. The posterior margin had the highest stress under posterior extension. The edge was subjected to the least stress; when the lateral flexion and the rotational position, the right edge was subjected to the most stress, and the leading edge was subjected to the least stress. (4) L5 had the largest stress in all six movements, and the stress was concentrated on the upper and lower articular processes and pedicles, especially on the right side. (5) In summary, for adolescent idiopathic scoliosis, different loads may cause different stresses and displacement values of the vertebral body or intervertebral disc under different positions. These results are of great significance for the treatment and prevention of scoliosis.
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BACKGROUND: Cornelia de Lange syndrome is a genetic disease with multiple developmental defects, of which NIPBL is the main pathogenic gene. OBJECTIVE: To investigate the effect of NIPBL gene on the proliferation and osteogenic differentiation of bene marrow mesenchymal stem cells. METHODS: The NIPBL+/- mice were constructed by NIPBL-Loxp and Cre mice and used as experimental group, and the wild-type NIPBL+/+ mice served as control group. Mouse bone marrow mesenchymal stem cells were isolated and cultured in the two groups. Cell proliferation was detected using cell counting kit-8 assay when thecells were passed to the third generation. Osteoblastic differentiation was then compared between two groups after osteogenesis induction. RESULTS AND CONCLUSION: The proliferation capacity of bone marrow mesenchymal stem cells in the experimental group was lower than that in the control group (P < 0.05). The activity of alkaline phosphatase in the experimental group was significantly lower than that in the control group on the 7th day of osteogenic induction (P < 0.05). The expression levels of osteogenic genes and proteins (Runx2 and OCN) in the experimental group were lower than those in the control group after osteogenic induction (P < 0.05). On the 21st day of osteogenic induction, results from alizarin red staining indicated there were more red calcium nodules in the control group than the experimental group under inverted microscope. These findings suggest that NIPBL gene knockout can reduce the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells.
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BACKGROUND: Percutaneous kyphosis is improved on the basis of vertebroplasty, which can well restore the height of compressed vertebral body and reduce bone cement leakage. In recent years, it has been widely used in the treatment of osteoporotic vertebral compression fracture. However, it is often reported that there are recurrent fractures of the enhanced vertebral body and adjacent vertebral body after surgery, and the related factors affecting the recurrent fracture are still controversial. OBJECTIVE: To identify the risk factors for the fractures secondary to percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures in the elderly by meta-analysis. METHODS: A comprehensive search was conducted for the studies published from January 2009 to April 2019 on the risk factors for secondary fractures after percutaneous kyphoplasty in the Cochrane Library, PubMed, CBM, CNKI and WanFang databases and manually as well. After the relevant data were extracted, statistical analysis was carried out with RevMan 5.3 software. RESULTS AND CONCLUSION: (1) The secondary fracture after percutaneous kyphoplasty for osteoporotic vertebral compression fracture was related to age [WMD=1.87, 95%C/ (0.79, 2.95), P 0.05], body mass index [WMD=-0.27, 95% Cl (-1.06, 0.51), P=0.49], cement volume [WMD=0.06, 95% Cl (-0.21, 0.32), P=0.68], surgical approach [OR=0.87, 95%C/(0.61,1.25), P=0.46], primary fracture was thoracolumbar segment (T11-L2) [OR=1.48, 95% C/(0.93, 2.38), P=0.1]. These results suggest that age, bone mineral density, bone cement leakage, correction of kyphosis angle after primary operation and recovery rate of vertebral height after primary operation may be the risk factors closely correlative to the secondary fracture after percutaneous kyphoplasty. There has not been enough evidence to support the associations between the secondary fracture and sex, body mass index, cement volume, surgical approach or thoracolumbar spine, and the above conclusions need to be studied and verified by more high quality literature in the future.
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BACKGROUND: Pedicle screw internal fixation has been widely used in the lumbar spine, and fixed application in thoracic vertebra has gradually been accepted. Considering the narrow thoracic pedicle, especially at T3-T9, pedicle screw always punctures the cortex and important adjacent structures. To avoid serious complications, researchers developed the external pedicle approach from the costal transverse process joint and the costal vertebra joint to the vertebral body, and then others designed a similar screw entry method, which can provide enough safe paths as long as the ribs are not penetrated. At present, the existing studies mainly focus on the upper and middle thoracic vertebrae in adults. OBJECTIVE: To measure the anatomical parameters of pedicle-rib unit screw fixation in thoracic vertebrae of preschoolers, and to explore their developmental regularity and morphological characteristics at different age groups and sexes, so as to provide theoretical basis for clinical practice. METHODS: Sixty-seven preschoolers aged 7-12 years old without bone destruction, tumor, deformity, degeneration or fractures at the spine and no history of spine related surgery were selected. Three-dimensional reconstruction was conducted after spiral CT scanning. The morphological structure of pedicle-rib unit was observed. The transverse diameter, length, inclination angle and safety angle range of pedicle-rib unit screw were measured and analyzed statistically to investigate the feasibility of screw on anatomy. All guardians of the children signed the informed consents, and the study was approved by the hospital ethical committee. RESULTS AND CONCLUSION: (1) The transverse diameter of the thoracic pedicle-rib unit was increased with age, and decreased first and then increased with the increase of vertebral sequence. The transverse diameter in males was larger than in females at the same age. (2) The length of pedicle-rib screw channel was significantly different in different age groups (P < 0.05), which showed a significant increase with age and a trend of first increase and then decrease with the increase of vertebral sequence. (3) Pedicle-rib unit screw placement showed that safety angle range was 18°-25°, including maximum safety scope in T1, followed by T|0, minimum in T4 and T5. (4) Thus, security angle range of pedicle-rib unit screw in children is narrower than that in adults. Compliance with the adult standards in screw placement may cause severe nerve damage to the nerves and blood vessels, so preoperative individualized screw placement should be carried out according to the CT results.
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BACKGROUND: Percutaneous vertebroplasty and percutaneous kyphopiasty are widely used minimally invasive surgery for vertebral compression fractures, spinal primary tumor and spinal metastasis. However, there were no bibliometric studies and mapping knowledge domains study regarding percutaneous vertebroplasty and percutaneous kyphopiasty. OBJECTIVE: To summarize and identify the papers related to percutaneous vertebroplasty and percutaneous kyphopiasty, and mapping knowledge domains of percutaneous vertebroplasty and percutaneous kyphopiasty. METHODS: Web of Science was retrieved for studies published from 1985 to 2018. The key words were TS = vertebroplasty OR kyphopiasty. All data were input into the Microsoft Excel 2016 and VOSviewer to identify publication number, publication year, publication country, publication organization, publication source, author, sum of times cited (including and excluding self-citation), average cited times and H-index. VOSviewer software was used to analyze the co-cited references, the co-cited authors and the co-occurrence of key words, and mapping knowledge domains. RESULTS AND CONCLUSION: (1) The research regarding percutaneous vertebroplasty and percutaneous kyphopiasty is one of the important research areas in spine surgery research domains. (2) USA dominates the research regarding percutaneous vertebroplasty and percutaneous kyphopiasty. The qualities of papers from Switzerland and England are relatively high while those from China and Italy are relatively low. (3) Some of the organizations that published most papers and high-quality papers include Mayo Clinic, Suzhou University, Johns Hopkins University, Cleveland Clinic Foundation and University of Bern. (4) Some of the journals that published most papers and high-quality papers include SPINE, EUROPEAN SPINE JOURNAL, AMERICAN JOURNAL OF NEURORADIOLOGY, JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. (5) Some of the authors that published most papers and high-quality papers include YANG HL, KALLMES DF, PFLUGMACHER R, DERAMOND H, CHIRAS J, FERGUSON SJ and MASALA S. (6) The key contents of percutaneous vertebroplasty and percutaneous kyphopiasty include osteoporotic vertebral compression fracture, tumor, bone cement, surgery, biomechanics and refracture.
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BACKGROUND: The number of rheumatoid arthritis patients undergoing total knee arthroplasty is increasing, but the postoperative early complications and related risk factors have not been reported. OBJECTIVE: To investigate the early acute complications and the risk factors after primary total knee arthroplasty in patients with rheumatoid arthritis. METHODS: Data of 300 patients (337 knees) with rheumatoid arthritis who received primary total knee arthroplasty at Affiliated Hospital of Qingdao University from September 2013 to May 2019 were retrospectively analyzed. There were 62 males and 238 females, with an age of (65.61±8.40) years old. All patients signed the informed consent, and the study was approved by the ethics committee of the hospital. The baseline data, comorbidities, preoperative examination, surgical data, other data of hospitalization and follow-up data were recorded. The risk factors of complications were analyzed. The receiver operating characteristic curve was used to assess the predictive value of risk factors for postoperative complications within 30 days after surgery in rheumatoid arthritis patients. RESULTS AND CONCLUSION: (1) Nine cases (3.33%) affected acute complications within 30 days after surgery. (2) Multivariate Logistic regression analysis showed that operation time, age, duration of disease and preoperative cerebrovascular disease were independent risk factors for postoperative complications within 30 days after total knee arthroplasty in rheumatoid arthritis patients. (3) Compared with the non-complication group, in the complication group, the operation time was longer (OR=1.023, 95%CI: 1.001-1.045, P=0.037), the age was increased (OR=1.163, 95%CI: 1.025-1.319, P=0.019), the duration of disease was longer (OR=1.110, 95%CI: 1.031-1.195, P=0.006), and the proportion of preoperative cerebrovascular disease was increased (OR=31.736, 95%CI: 4.053-248.517, P=0.001). (4) The receiver operating characteristic curve to predict the complications in patients with rheumatoid arthritis within 30 days after total knee arthroplasty showed that the area under the curve of age, duration of disease and operation time were 0.693, 0.865 and 0.685, respectively.
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BACKGROUND: With the aging of population, brittle fracture diseases have attracted more and more attention from clinicians. Bone mineral density detection cannot meet the risk assessment of brittle fracture. As one of the new directions and methods to evaluate the risk of brittle fracture, cortical thickness has been studied and discussed by more and more scholars. OBJECTIVE: To explore the correlation of bone cortical thickness values and X-ray gray values in different planes of proximal femur with hip brittle fracture in women aged over 50 years old under X-ray DR photography, so as to evaluate the most appropriate measurement plane for predicting the risk of hip brittle fracture in women among different planes of proximal femur. METHODS: According to the inclusion criteria, relevant clinical data of 100 female patients aged over 50 years old who underwent X-ray DR pelvic radiograph examination at Department of Radiology of the Ninth Affiliated Hospital of Guangxi Medical University from July 2018 to June 2019 were collected. All patients signed the informed consents and the study was approved by the ethics committee of the hospital. The measurement planes of cortical thickness of the proximal femur were designed to be the middle part of femoral neck, within 1 cm above the lesser trochanter, and within 1 cm below the lesser trochanter, with a total of three groups of measurement planes. The gray value of X-ray was measured by taking the line between the middle point of the great rotor and the small rotor as the rectangular diagonal line to take the rectangular area for measurement. RESULTS AND CONCLUSION: (1) Women aged 50-64 years were as group A (n=50) and those aged 65 years and older were as group B (n=50). (2) The cortical thickness and X-ray gray value within 1 cm below the lesser trochanter, and within 1 cm above the lesser trochanter in the group B were significantly lower than those in the group A; fracture rate was higher in group A than in group B (P 0.05). (3) On the whole, cortical thickness values were highest in the within 1 cm below the lesser trochanter, followed by within 1 cm above the lesser trochanter and lowest in the middle part of the femoral neck (P 0.05). (5) The difference of cortical thickness within 1 cm below the lesser trochanter and within 1 cm above the lesser trochanter between fracture and non-fracture groups in the group A was significant (P 0.05). At the age above 50 years, the difference of cortical thickness and X-ray gray value in each measured plane between fracture and the non-fracture groups was significant (P < 0.05). (6) To conclude, the cortical thickness becomes thinner and the gray value of X-ray becomes smaller, and the possibility of brittle fracture of hip becomes higher. When assessing the risk of hip fracture in women aged over 50 years using cortical thickness of the proximal femur, measurement within 1 cm below the lesser trochanter is recommended.
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BACKGROUND: A large amount of literature has been published on the vertebral pedicle morphology at thoracolumbar segments in adults, but little is known about the morphology of pedicles in adolescents, especially in Asian populations. Adolescent spine disorders are increasing and there are few precise morphological studies. OBJECTIVE: To investigate the anatomy of lumbar vertebrae of adolescents aged 12-15 years in Inner Mongolia, provide detailed information for pedicle screw placement, determine the safe and appropriate screw size, and provide data reference for screw size design. METHODS: The normal chest and lumbar CT data of 65 adolescents aged 12-15 years in Inner Mongolia were collected and divided into two groups, 31 cases of 12-13 years old, and 34 cases of 14-15 years old. The raw data of the thoracic and lumbar vertebrae images scanned continuously were imported into Mimics 21.0 for analysis and measurement in DICOM format. Pedicle width, pedicle height, transverse diameter, longitudinal diameter, pedicle length, pedicle outer declination, pedicle maximum external angle, pedicle head inclination, and pedicle area were measured. RESULTS AND CONCLUSION: (1) The L1-L4 pedicle width in the two groups was less than pedicle height, and pedicle width and pedicle height at L5 were similar. The pedicle width determined the screw diameter, which was larger in males than in females. (2) In 12-13 years old, the screw length at L1-L5 was between 40-45 mm. In 14-15 years old, the screw length was between 40-45 mm at L1-L4, and 45-50 mm at L5. (3) The laws of the two groups were the same. The transverse diameter of spinal canal was significantly larger than longitudinal diameter of spinal canal (P < 0.05), and there was no significant difference between men and women. (4) The transverse pedicle angle: In 12-13 years old, L1-L2 had small change, L2-L5 gradually increased; in 14-15 years old, L1-L5 gradually increased; it is larger in males than in females in both groups. (5) Maximum transverse pedicle angle: The two groups had the same law. L1-L5 gradually increased, and decreased with age. There was no significant difference between left and right sides and sexes. There was significant difference among different ages (P < 0.05). (6) The sagittal pedicle angle: The in 12-13 years old, 3°-8°; in 14-15 years old, 0°-5°. The value decreased with age, and there was significant difference between men and women in L3-L4 (P < 0.05). (7) Pedicle area: The two groups had the same rules. L1-L5 gradually increased, and L4-L5 had a clear trend of change. (8) Analysis of pedicle parameters showed that the size of the screws in the lumbar vertebrae of normal adolescents was suitable for the clinician to grasp the anatomy of the lumbar spine and improve the accuracy of clinical operation.
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BACKGROUND: A large amount of literature has been published on the vertebral pedicle morphology at thoracolumbar segments in adults,but little is known about the morphology of pedicles in adolescents, especially in Asian populations. Adolescent spine disorders are increasing and there are few precise morphological studies. OBJECTIVE: To investigate the anatomy of lumbar vertebrae of adolescents aged 12-15 years in Inner Mongolia, provide detailed information for pedicle screw placement, determine the safe and appropriate screw size, and provide data reference for screw size design. METHODS: The normal chest and lumbar CT data of 65 adolescents aged 12-15 years in Inner Mongolia were collected and divided into two groups, 31 cases of 12-13 years old, and 34 cases of 14-15 years old. The raw data of the thoracic and lumbar vertebrae images scanned continuously were imported into Mimics 21.0 for analysis and measurement in DICOM format. Pedicle width, pedicle height, transverse diameter, longitudinal diameter, pedicle length, pedicle outer declination, pedicle maximum external angle, pedicle head inclination, and pedicle area were measured. RESULTS AND CONCLUSION: (1) The L1-L4 pedicle width in the two groups was less than pedicle height, and pedicle width and pedicle height at L5were similar. The pedicle width determined the screw diameter, which was larger in males than in females. (2) In 12-13 years old, the screw length at L1-L5 was between 40-45 mm. In 14-15 years old, the screw length was between 40-45 mm at L1-L4 , and 45-50 mm at L5 (3) The laws of the two groups were the same. The transverse diameter of spinal canal was significantly larger than longitudinal diameter of spinal canal (P<0.05), and there was no significant difference between men and women. (4) The transverse pedicle angle: In 12-13 years old L1-L2 had small change,L2-L5 gradually increased; in 14-15 years old, L1-L5 gradually increased; it is larger in males than in females in both groups. (5) Maximum transverse pedicle angle: The two groups had the same law. L1-L5 gradually increased, and decreased with age. There was no significant difference between left and right sides and sexes. There was significant difference among different ages (P<0.05). (6) The sagittal pedicle angle: The in 12-13 years old, 30-80; in 14-15 years old, 00-50. The value decreased with age, and there was significant difference between men and women in L3-L4 (P<0.05). (7) Pedicle area: The two groups had the same rules. L1-L5 gradually increased, and L4-L5 had a clear trend of change. (8) Analysis of pedicle parameters showed that the size of the screws in the lumbar vertebrae of normal adolescents was suitable for the clinician to grasp the anatomy of the lumbar spine and improve the accuracy of clinical operation.
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BACKGROUND:Mechanical stress plays an important role in the progressive collapse in osteonecrosis of the femoral head.Therefore,the bone structure of weight-bearing area may be the risk factor for collapse.OBJECTIVE:To investigate the relationship between the bone preservation of weight-bearing area and collapse progression in necrotic femoral head.METHODS:Eighty-seven patients (102 hips) with ARCO stage Ⅱ osteonecrosis of the femoral head,diagnosed by MRI,were enrolled.All patients underwent a natural progression.Collapse and bone involvement of the weight-bearing area were viewed by anteroposterior and frog-leg lateral radiographs.According to the location of the necrotic lesion on the anterolateral portion of the femoral head,the necrosis was divided into three types:type 1,the posteromedial and central portions;type 2,part of the anterolateral portion;type 3,the entire anterolateral portion.The collapse rate and the time to collapse in different types were assessed.RESULTS AND CONCLUSION:(1) All patients were followed up for 3-58 months.(2) Of the 60 hips with collapse,46 (76.7％) hip collapse was identified on anteroposterior radiograph.On frog-leg lateral radiograph showing collapsed femoral head could be identified in 57 (95.0％) hips,which was significantly different (P ＜ 0.01).(3) In all 102 hips,the collapse rate in type 3 osteonecrosis of the femoral head was significantly higher than that of type 2 osteonecrosis of the femoral head (P ＜ 0.001),and the time to collapse was markedly shortened.None collapse occurred in all six hips with type Ⅰ osteonecrosis of the femoral head during follow-up.(4) In summary,preservation of anterolateral portion is associated with potential collapse progression in necrotic femoral head.
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BACKGROUND:HLA-DRB1 is related to the pathogenesis of alergic rhinitis. Construction ofHLA-DRB1 gene knockout animal models not only elucidates the pathogenesis of alergic rhinitis, but also provides a good way for the elucidation of the pathogenesis of alergic rhinitis-related diseases. OBJECTIVE:To establish the HLA-DRB1gene knockout animal models. METHODS:Homozygous, wild-type and heterozygous mice were obtained by inbreeding of the heterozygous mice. Confirmed by gene and protein identification, 24 female wild-type (H2-eb1+/+) mice and 12 H2-eb1-/-mice aged 8 weeks were selected according to the random number table. 12 H2-eb1+/+ mice and 12 H2-eb1-/- mice were sensitized with ovalbumin to establish the mouse models of alergic rhinitis. Another 12 mice were sensitized with PBS as comparison. RESULTS AND CONCLUSION:Compared with the control mice, serum levels of ovalbumin-specific IgE and interleukin-4 were significantly increased, while serum level ofγ-interferon was significantly decreased in the mouse models of alergic rhinitis. Serum levels of IgE and interleukin-4 were lower, while serumγ- interferon level was higher, inH2-eb1-/-gene knockout mice of alergic rhinitis than those in the H2-eb1+/+ gene knockout wild-type mice. These results suggest thatH2-eb1 gene may play an important role in regulating Th1/Th2 imbalance in the pathogenesis of alergic rhinitis.